Pelvic Pain

What is pelvic pain?

Pelvic pain is a common problem in women. The cause is often not
clear. It can have many causes. In some cases, no disease can be found. Pelvic pain can
be either acute or chronic. Acute means the pain is sudden and severe. Chronic means the
pain either comes and goes or lasts for months or longer. Pelvic pain that lasts longer
than 6 months and doesn't improve with treatment is known as chronic pelvic pain. Pelvic
pain may start in genital or other organs in and around the pelvis. In some cases, it
may be psychological. This can make pain feel worse or cause pain, when no physical
problem is found.

What causes pelvic pain?

Pelvic pain can have many causes,
such as:

Inflammation or irritation of nerves
caused by injury, fibrosis, pressure, or peritonitis

Muscle cramps

A pregnancy that happens outside the
uterus (ectopic pregnancy)

Pelvic inflammatory disease (PID), an
infection of the reproductive organs

Twisted or ruptured ovarian cyst

Miscarriage or threatened
miscarriage

Urinary tract infection

Appendicitis

Ruptured fallopian tube

Some of the conditions that can
lead to chronic pelvic pain may include:

Menstrual cramps

Endometriosis

Uterine fibroids (growths on or in the
uterine wall)

Scar tissue between the organs in the
pelvic cavity

Endometrial polyps

Cancers of the reproductive tract

Other problems in the digestive, urinary, or nervous
systems

What are the symptoms of pelvic pain?

These are examples of the different
types of pelvic pain most commonly described by women, and their possible cause or
origin. Always talk with your healthcare provider for a diagnosis.

Type of pain

Possible cause

Local pain

May be from an
inflammation

Cramping

May be caused by spasm
in the intestine, ureter, or appendix

Sudden start of
pain

May be caused by a
short-term lack of blood supply because of a problem with blood
flow

Slowly-developing pain

May be from
inflammation of the appendix or blockage in the intestines

Pain of the entire
abdomen

May be a buildup of
blood, pus, or stool in the bowels

Pain made worse by
movement or during exam

May be from irritation
in the lining of the abdomen

How is pelvic pain diagnosed?

Tests will be done to find the
cause of the pelvic pain. Your healthcare provider may ask you questions about the pain
such as:

Tell your healthcare provider all
you can about the timing of the pain and other symptoms related to eating, sleeping,
sexual activity, and movement. This can help with a diagnosis.

The healthcare provider will give
you a physical and pelvic exam. You may have tests such as:

Blood tests

Pregnancy test

Urinalysis

Culture of cells from the cervix

You may also have tests such as:

Ultrasound. This test uses
high-frequency sound waves to create an image of organs.

CT scan. This is an imaging
test that uses X-rays and a computer to make detailed images of the body. A CT scan
shows details of the bones, muscles, fat, and organs, and any abnormalities that may
not show up on an ordinary X-ray.

MRI. A noninvasive procedure
that produces a 2-D view of an internal organ or structure.

Laparoscopy. A minor surgical
procedure in which a laparoscope, a thin tube with a lens and a light, is inserted
into an incision in the abdominal wall. Using the laparoscope to see into the pelvic
area, the healthcare provider can determine the locations, extent, and size of any
endometrial growths.

X-ray. A small amount of
radiation is used to produce images of bones and internal organs onto film.

Colonoscopy. In this test, the
healthcare provider can view the entire length of the large intestine. It can often
help find growths, inflamed tissue, ulcers, and bleeding. It is done by putting a
long, flexible, lighted tube (colonoscope) in the rectum and up into the colon. The
colonoscope lets the healthcare provider to see the lining of the colon, remove
tissue to test, and treat some problems that are found.

Sigmoidoscopy. This test lets
the healthcare provider examine the inside of a part of the large intestine. It can
find the causes of diarrhea, abdominal pain, constipation, abnormal growths, and
bleeding. A short, flexible, lighted tube (sigmoidoscope) is put into the rectum. The
scope blows air into the intestine to inflate it and make viewing the inside easier.

How is pelvic pain treated?

Treatment may include:

Antibiotics

Anti-inflammatory

Pain medicines

Relaxation exercises

Birth control pills

Surgery

Physical therapy

If a physical cause can’t be found,
your healthcare provider may refer you for counseling. This can help you cope with
chronic pain. In other cases, you may benefit from:

Nutrition changes

Environmental changes

Physical therapy

Pain management

Key points about pelvic pain

Pelvic pain is a common problem in
women. Its cause is often unclear.

Pain can be acute or chronic.

Treatment will depend on the cause as
found by the physical exam and tests.

Treatment may include medicines,
surgery, physical therapy, or pain management.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.